This Mentored Patient-Oriented Research Career Development application is designed to provide the scholarly training, mentorship, and support necessary for the candidate to develop into an independent investigator. The candidate's goal is to gain expertise in the development and testing of effective and cost-beneficial evidence-based rehabilitative health promotion interventions in partnership with people with spinal cord injury (SCI) in community settings. To achieve this goal, a focused career development plan is proposed to 1) gain expertise in the rigorous conduct of theoretically grounded, community-based health promotion intervention research, 2) develop proficiency in the use and application of research designs that incorporate both qualitative and quantitative methods, 3) enhance skills in community-based participatory research (CBPR), and 4) advance competence in analytical and evidence-based decision making skills related to intervention research with an emphasis on interpretation of health related outcomes and cost effectiveness. The Medical University of South Carolina provides a rich training environment that includes senior experts in community-based participatory research, health disparities research, and applied SCI research. The candidate has identified mentors with complementary expertise in the development and implementation of randomized controlled trials of community-based health promotion interventions with vulnerable populations using a CBPR approach, as well as measurement and interpretation of health and social outcomes after SCI. The mentoring team will be responsible for monitoring and evaluation of the candidate's progression during the five-year training plan. The research plan, which builds on the training objectives, is designed to respond to a recent NIH initiative to incorporate CBPR approaches to more effectively investigate health issues in high-risk communities. The proposed work also incorporates the National Health Promotion and Disease Prevention Objectives for 2020 to address the environmental factors that contribute to our health. The research plan includes strategies to address health promotion after SCI beyond the level of the individual and incorporate an ecological approach to identify and address issues in the physical and social environment that affect health after SCI. The objective of the proposed two-phase feasibility study is to investigate a novel ecological approach to health promotion after SCI, using a CBPR approach, in partnership with a local center for independent living. Building on evidence from other fields, the PIs propose an intervention using community-based peer navigators with SCI to proactively mitigate barriers and facilitate access to health care and other community-based services by people with SCI. Overall goal is to reduce rehospitalizations and secondary conditions and improve community participation and satisfaction with life after SCI. Upon training completion, the candidate will be prepared to design, obtain funding for, and conduct a large-scale randomized controlled trial of a community-based health promotion intervention for and in partnership with people with SCI. This future research will provide empirical data to support development of cost-effective, evidence-based rehabilitative health promotion interventions to improve health and quality of life of this vulnerable population. PUBLIC HEALTH RELEVANCE: This research addresses the recent NIH initiative to incorporate community-based participatory research approaches to more effectively investigate health issues of greatest relevance to high-risk communities and the National Health Promotion and Disease Prevention Objectives for 2020 to address the environmental factors that contribute to our health. The strategy to address health promotion after spinal cord injury (SCI) moves beyond the level of the individual and incorporates an ecological approach to identify and address issues in the physical and social environment that influence health. The PIs propose to adapt the role of the peer navigator to promote optimal outcomes after SCI by providing participants with the support needed to reduce rehospitalizations and secondary conditions and maximize community participation and satisfaction with life after SCI.